Improve Your Shoulders with the Elbow Walk

There is no doubt that many people have cranky shoulders. This is especially evident when they try to lift their arms fully overhead, or when they’re trying to military press with proper form. When you see a guy or gal excessively arch the lower back when pressing weights overhead, it’s likely that compensation is due to a lack of overhead shoulder mobility.

During my first year of the Doctor of Physical Therapy (DPT) program at USC, I got to fully dissect a cadaver. I’ll never forget the week I spent on the shoulder region. Once you see how many muscles, ligaments, vessels, and structures are jam-packed within the shoulder, it’s amazing we could ever lift our arms overhead without pain. Furthermore, the timing and sequencing of muscle activation the nervous system must coordinate while reaching overhead is pretty astonishing.

Indeed, when you consider the plethora of structures within the shoulder complex, and the motor control that’s required for smooth, full range of motion movement, it’s no surprise why a lack of overhead mobility is a widespread problem in the fitness community.

It’s worth mentioning here that there can be 100 different reasons why you lack overhead mobility. And this is also why there are over 100 different special tests used by physical therapists and orthopedic doctors for assessing the shoulder complex. But there are a few common problems that most people need to correct.

One of my favorite corrective exercises to improve overhead mobility is the elbow wall walk. The benefits of this exercise are numerous, but there are three primary goals when you do it correctly. First, it activates the shoulders’ external rotators, which helps pull the head of the humerus into its ideal position. Second, the exercise activates the serratus anterior, a muscle that’s essential for upward rotation of the scapula. Third, the elbow wall walk teaches your client to reach overhead without extending the lumbar spine.

Test Yourself

The elbow wall walk is a terrific shoulder activation drill to perform before upper body training or Olympic lifts. Nevertheless, if you or your client has problems with overhead mobility it’s important to determine if this exercise provides the benefit you seek. You’ll perform 3 sets of the elbow wall walk, and each set should last 45-60 seconds.

  • Do you lack the ability to reach your arms fully overhead? Perform an overhead reach and have your buddy take a picture of your end range of motion. Measure the shoulder joint angle using one of the many Smartphone apps. After that, perform the elbow wall walk, and then retest (and remeasure) your shoulder joint angle to determine if it improved.
  • Shoulder pain when reaching or pressing overhead? Find the overhead position that causes discomfort, and rate it on a scale of 1-10 with 10 being “emergency room” pain. Perform the elbow wall walk, then retest the overhead position and see if the pain intensity has decreased.
  • Poor shoulder stability when holding weights or a barbell overhead? Perform the elbow wall walk, then retest the exercise to determine if your shoulder stability has improved.

The elbow wall walk requires a TheraBand or some type of light resistance band that can be wrapped around each hand. Be sure to “walk” the elbows up the wall very slowly during this drill, and follow the cues outlined in the video below.

Give this activation/strengthening drill a try and it will likely decrease shoulder discomfort and improve overhead performance.

Stay Focused,
CW

Align Your Pelvis to Increase Performance

The term “core” is thrown around a lot these days. Most people think of the core as being the abdominals, or midsection. But if we consider the classic definition of the word, which is “the central part of something,” it means your body’s true core is the pelvis. The pelvis is where the upper and lower segments attach, so it’s the central part of your body.

This also means that if your pelvis is out of proper alignment, it can create unwanted compensations up and/or down your body’s chain. Indeed, problems in the pelvis can cause knee or foot pain, and it can cause low back or shoulder pain.

What’s relevant here are three of the articulations within the pelvis: the two sacroiliac (SI) joints, and the pubic symphysis. These joints make it possible for parts of the pelvis to rotate or tilt, due to the attached muscles being shortened (i.e., overactive) or lengthened (i.e., weak/inhibited).

Now, it’s important to mention here that these joints don’t allow for much motion. In fact, some clinicians still question if they can move at all. But anyone that has a hypermobile pelvis or SI joint pain will tell you they can move. And when they move the wrong way, pain and poor performance follow.

The Postural Restoration Institute (PRI) teaches courses that focus heavily on restoring pelvic alignment. I’ve taken their Myokinematic Restoration and Pelvic Restoration courses, and I recommend them to any progressive trainer or clinician.

Nevertheless, becoming proficient at assessing and correcting pelvic alignment can be a complicated task. There are a myriad of muscles, ligaments and tendons in play, and any one of them can be the culprit. Physiotherapist, Diane Lee, is one of the experts that’s giving seminars to help progress this area of practice. I’m talking here about something called “muscle energy techniques,” which simply means you’re activating key muscles to improve function within the body.

Test Yourself

Before we get to the muscle energy technique that I use to restore pelvic function, it’s important to begin by testing yourself (or a client) so you’ll know if the drill worked. I recommend tests similar to the ones I outlined in the Ultimate Glute Development article I wrote last week.

  • Stiff hamstrings? Do a standing toe touch assessment, then perform the pelvic alignment correction and immediately retest it.
  • Knee or low back pain? Do a movement that causes you to feel the discomfort, then perform the pelvic alignment correction and immediately retest it.
  • Need more hip mobility for the squat, lunge or deadlift? First perform the pelvic alignment correction, and then test if your hips/low back feel looser during the exercise.

For the following Pelvic Alignment Correction, you’ll need a PVC pipe or strong dowel, as well as a basketball or light medicine ball that’s a similar size.

When should you do this drill? First in your workout. It doesn’t make any sense to warm-up, with even a light jog, if your pelvis is out of alignment. To paraphrase Gray Cook: Don’t put fitness on top of dysfunction.

Give the following drill a try before your next sprint, squat, deadlift or jump session, and your hips and alignment will probably feel much better.

Stay Focused,
CW

Ultimate Glute Development

Everyone wants better glutes, whether you’re a guy or gal, athlete or non-athlete. That’s because glutes that are awesomely developed not only make your body look better, but they can also drastically improve your performance. When the glutes are strengthened and built using the correct combinations of exercises, you’ll run faster, jump higher and improve the strength of all your lower-body lifts.

In order to build a muscle to it’s highest level of size and performance, all of its fibers should be recruited by the end of a workout. The glutes are a tri-planar muscle, which means it can function in all three planes of movement:

  • Sagittal plane = hip extension
  • Frontal plane = hip abduction
  • Transverse plane = hip external rotation

The problem is that most people only train the sagittal plane function of the glutes: hip extension. I’m talking here about the typical squat, deadlift and lunge variations.

Last fall I spent four months working with Christopher Powers, Ph.D., at his Movement Performance Institute (a glute-focused sports medicine facility if there ever was one). I worked with athletes and non-athletes that had a myriad of knee, low back or hip problems.

The early stages of Professor Powers’ system focuses heavily on strengthening the glutes in the frontal and transverse planes – hip abduction and hip external rotation, respectively. Pure hip extension isn’t usually trained until about 6 weeks into the system.

There were two key observations I made after training athletes primarily in hip abduction and external rotation for up to 6 weeks straight:

  • Their glutes got substantially larger
  • Their hip extension strength increased

Their glutes got bigger because they were recruiting muscle fibers that perform hip abduction and external rotation, which had been neglected in the gym from doing nothing but squats, lunges and deadlifts.

Prof. Powers has been a pioneer in research that demonstrates a link between frequent glute activation and a stronger mind-muscle connection, which is an essential component of strength and hypertrophy development. So even though pure hip extension wasn’t trained, that movement got stronger because the brain was better able to recruit the entire gluteal fibers in any future task.

My point here is that ultimate glute development requires a strong emphasis on hip abduction and hip external rotation. Those two movement planes must be frequently trained in order to build the glutes to the highest level of size and performance.

Test Yourself

Before you watch the video where I outline my favorite 7-minute glute-building sequence, test yourself (or one of your clients).

  • Stiff hamstrings? Do a standing toe touch assessment, then perform the glute sequence and immediately retest it.
  • Knee or low back pain? Do a movement which causes you to feel the discomfort, then perform the glute sequence and immediately retest it.
  • Need to improve your squat, lunge, deadlift, sprint or vertical jump? Do the following sequence twice each day for 2 weeks, then retest the exercise you’re trying to improve. Your performance will definitely go up!

The following Ultimate Glute Development sequence requires a mini-band. I use the bands made by Perform Better, which can be found at this Amazon link. Most females should start with a yellow mini-band; males can start with a green. The key is to progress the band tension as your strength improves.

  • Goal for males: perform the entire Ultimate Glute Development sequence with a black Perform Better mini-band.
  • Goal for females: perform the entire Ultimate Glute Development sequence with a blue Perform Better mini-band.

Here’s the Ultimate Glute Development sequence, a collection of my favorite glute-building exercises, all crammed into a 7-minute drill. Do this sequence at least once per day (preferably twice), at the beginning of your regular workouts or as a stand-alone drill.

I highly recommend you make this a foundational activation sequence for you and your clients, for years to come.

Stay Focused,
CW

Get Your Feet in Control

The human foot is a marvel of complex engineering. Each one is made up of 26 bones, 33 joints and over 100 soft tissue structures that form muscles, tendons and ligaments. Not to mention the 150,000 nerve endings that you have on the bottom of each foot.

Your body needs all of those components to be working at full capacity in order to achieve an impressive vertical jump, sprint or deadlift. But more often than not, your feet have lost that ability, and the negative consequences can be far-reaching. Indeed, progressive doctors that specialize in treating jaw disorders (e.g., TMJ) look at the patient’s foot posture and control when designing a treatment plan.

Many active people take up to 10,000 steps per day. Pair that with the fact that most people don’t wear properly-fitted shoes, or have stiffness in one or more of the 33 joints, and you’ve got a perfect scenario for lousy foot mechanics that can cause ankle, knee, low back or the previously mentioned jaw pain.

Shoes are often the culprit, because they impair isolated action of each toe. And if you wear high heels or cowboy boots, the situation becomes exponentially worse because your toes are crammed together like clowns in a compact car during a Shriner’s parade. This results in poor motor control of your feet – essentially, your feet become “dumb” since your brain loses the ability to effectively control their joints and soft tissues.

Test Yourself

Here’s a simple, basic test to determine if you have adequate motor control of your feet. Stand barefoot with your feet shoulder width apart. Can you lift the big toe without elevating the other four toes? Can you elevate the four smaller toes while the big toe remains on the ground?

If you weren’t able to pass the test, your feet lack the motor control they need. Practice this drill throughout the day while seated, and then progress to the standing version since it’s more challenging. It will probably take a few weeks to get it right, and at first you might need to use a free hand to hold down the toe(s) that should remain static.

The next step is to focus on the shoe dilemma. Remember, regular shoes will keep your toes from moving freely. The solution is to wear toe socks, which isolate the toes so your brain can reconnect with each one. You can find them on Amazon at this link.

And for the times when you want to walk or lounge around the house barefoot, you can find rubber toe spreaders on Amazon at this link.

Now you have a simple way to test, and improve the motor control of your feet. And when you don’t feel like practicing the motor control drill, be sure to wear toe socks or rubber toe spreaders so your toes can come back to life. Your ankles, knees, low back – and maybe even your jaw – will reap the rewards.

Stay Focused,
CW

How to Run Without Pain

Since 2017 is just around the corner, droves of people will be lacing up their running shoes to shed what was gained in 2016. Yep, come January 2nd everyone will love to run…until about January 15th. That is about how long it takes before shin splints or knee pain really kicks in.

First, I stand by the assertion that you should get fit to run, not the other way around. Whether you’re jogging or sprinting, a high level of strength is required throughout the ankles, knees, and hips. Running is an advanced exercise because it requires much more single-limb stability strength than most people have. Indeed, people that are relatively unfit would be much better off doing 200-300 fast, quarter squats with no additional load, spread over 15 minutes as their “cardio.”

But telling a guy or gal not to do something as simple, and seemingly effective, as running in the new year is a lesson in futility. Hundreds of thousands of people will start doing it in January, so I might as well outline the steps they can take to minimize joint stress.

Limit running to 20 minutes at first: It is tempting to go balls-to-the-wall at first in order to hasten fat loss, but that’s the quickest route to injury and pain. Most people want to start jogging 45-60 minutes in the new year, and unless you’ve been a consistent runner in late 2016, that’s a bad idea. Limit your duration of running to 20 minutes, every other day for the first few weeks. Also, run slower than you think you can go. When you’re out of shape it takes very little exercise to ramp up your metabolism and burn fat. Take advantage of it, and your joints will thank you.

Wear Hoka One shoes: All the technique and training advice will do little if your shoes are worn out, which causes faulty running mechanics. You can tell a lot about how people run by looking at their souls…er, I mean, soles. Do you see considerable wear on the corners? If so, it’s time to get a new pair. I suggest Hoka One running shoes since my clients favor them most.

Increase your step rate approximately 10%: Start by running at a pace that’s most natural for you, and then shorten your stride so you have to take about 10% more steps without slowing your speed. Research by Heiderscheit et al 2011 and Luedke et al 2016 demonstrate that a shorter stride length (i.e., increased step rate) will provide three benefits:

  • Less impact forces to the knees, shins, and hips.
  • Less impact forces that can cause knee valgus.
  • Greater metabolic demand while running.

So increasing your step rate will minimize stress to your joints and augment the amount of calories you burn while running. You can’t beat that combination.

Roll your plantar fascia with a lacrosse ball: Research by Novacheck 1998 demonstrates that stress forces within the plantar fascia can reach triple your body weight while running. Since that thick band of tissue on the bottom of each foot takes a real beating, spend a minute or so rolling each bare foot over a lacrosse ball before and after running to keep the plantar fascia supple and healthy. Furthermore, the bottom of each foot has 150,000 or more nerve endings that, when stimulated, can relieve tension throughout the hamstrings and low back.

Now you have four tips that will help you run pain-free well into the new year.

Stay Focused,
CW

Should you ice it?

blog-ice

At one time in your life it’s likely that you’ve had an injury, such as an ankle sprain or hamstring strain. It’s also likely that you applied ice to the damaged tissues, probably because your physician or physical therapist told you to do so.

Was icing that sprained ankle a good idea? It depends.

Let’s start by covering the intended goals of icing. There are four of them:

  • Limit edema formation via vasoconstriction, which reduces the metabolic and vasoactive agents that contribute to inflammation..
  • Reduce pain via decreased nerve conduction velocity.
  • Facilitate muscle relaxation via decreased neural activity.
  • Limit secondary hypoxic tissue injury via decreased metabolic and oxygen demand of living tissues.

Applying ice to an injury will reduce inflammation. That sounds like a good thing, but it might not be.

You see, inflammation is a natural part of the healing process. After an injury, the inflammation process kicks into gear and releases macrophages, which are a type of white blood cells that eat up cellular debris at the site of injury (macrophages literally means “big eaters”). When you ice a body part, vasoconstriction of the blood vessels decreases the amount of macrophages that can arrive at the scene of damage.

The other benefit of macrophages comes from the release of insulin-like growth factor 1 (IGF-1) at the site of damage to promote tissue healing. Therefore, it appears that icing can slow the healing process, and that’s obviously something you don’t want.

However, research demonstrates two possible benefits ice can provide after an injury.

First, it reduces pain. That’s important because pain can change your brain for the worse – specifically, at the somatosensory cortex. Suffering through high levels of pain, when it’s not necessary, will increase the time it takes for you to clear it from your mind.

Second, icing can promote muscle relaxation by decreasing neural activity to the cooled area. This can be beneficial when muscles are overridden with protective tension and filled with painful trigger points. However, this also means that icing can reduce your strength and power. So don’t ice your quads before a heavy set of squats.

So back to that ankle sprain you iced after trying to impress the skaters at the park. If your goal of icing was to expedite healing, it probably wasn’t a good strategy. But if your goal was to reduce pain and promote tissue relaxation, well done!

If you choose to ice an injury, how long should it be applied? There are five stages of sensation when you apply ice to the skin, and they occur in this order:

  • Cold
  • Stinging
  • Burning
  • Aching
  • Numbness

Once you feel numbness in the area, stop icing because the possible benefits it can provide are maxed out at that point. Furthermore, icing beyond the point of numbness increases the risk of tissue damage. This is one of the reasons why icing an area with impaired circulation or damaged nerves is a bad idea.

Even though rest, ice, compression and elevation (RICE) has been viewed as the gold standard recovery protocol for decades, there’s always room for progress. Indeed, Gabe Mirkin MD, the sports medicine doctor that created the RICE acronym back in 1978, has distanced himself from it. Dr. Mirkin now recommends moving sooner rather than later (after it’s confirmed there are no broken bones), applying ice only to reduce pain within the first 6 hours after injury, and compression/elevation if there’s swelling.

In summary, whether or not you ice after an injury depends on your goal. If you’re trying to reduce pain and calm trigger points, stick with it. But if it’s been more than 6 hours since your injury, keep in mind that icing will reduce inflammation to that area, which can slow recovery.

Finally, this discussion about icing an injured body part shouldn’t be confused with cryotherapy in general. There’s some evidence that entering a cryogenic chamber for a few minutes, thus exposing the entire body to a frigid temperature, might promote recovery and potentially provide some health benefits. We’ll have to wait and see how that pans out.

Stay Focused,
CW

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